Clinical Study Of Metabolic Bone Disease Related Risk Factors In Premature Infants

Objective:Metabolic bone disease of premature infants is a metabolic disease caused by the disorder of calcium and phosphorus metabolism in premature infants.The main reason for this disease is that the decrease of bone mineral content leads to the change of bone,which increases the fragility of bone and increases the risk of fracture of premature infants,affecting the long-term linear growth.With the progress of perinatal medicine in China,the success rate of treatment for premature infants has been gradually improved in recent years.Through the clinical study of metabolic bone disease of preterm infants,this study analyzed the risk factors that may lead to metabolic bone disease of preterm infants,hoping to provide help for early prevention and reduction of metabolic bone disease of preterm infants,improve the quality of life of children and improve the prognosis.Methods:This study is a retrospective study.A total of 100 premature infants who were admitted to the neonatal intensive care unit(NICU)of the affiliated hospital of taishan medical college within 24 hours after birth between January 2016 and October 2018 were collected.25 patients diagnosed with metabolic bone disease of premature infants after discharge were selected as the case group(that is,the serum inorganic phosphorus concentration < 1.6 mmol/L,5 mg/d L,accompanied by the increase of serum alkaline phosphatase(ALP)concentration > 600U/L).According to the sex ratio of 1:1,75 patients with complete data during the same period of hospitalization,with gestational age less than34 weeks and hospitalization time more than 4 weeks,were selected as the control group.At the same time a detailed record of all premature gestational age,birth weight,sex,whether prenatal application hormone,whether merger gestational hypertension,gestational diabetes,whether application of mechanical ventilation(including a invasive ventilator and noninvasive ventilator),parenteral nutrition,vitamin D supplement dose time,bronchial pulmonary hypoplasia,sepsis and other parameters.After detailed statistical clinical data,SPSS20.0 statistical software was used for data analysis to screen out disease-related factors,and Logistic regression statistical analysis was used to select risk factors related to metabolic bone disease of premature infants.Result:1.Univariate logistic regression analysis(see table 1 for details)showed that:gestational age,birth weight,intravenous nutrition time,mechanical ventilation(including invasive ventilator and non-invasive ventilator),bronchopulmonary dysplasia and other factors had statistical significance on the occurrence of metabolic bone disease in premature infants,P<0.05;Gender,prenatal hormones,gestational hypertension/gestational diabetes mellitus,800 IU vitamin D supplement,sepsis and other related factors had no statistical significance on metabolic bone disease of premature infants,P>0.05.2.Multivariate logistic analysis(see table 2)showed that birth weight and bronchopulmonary dysplasia were correlated with the occurrence of metabolic bone disease in premature infants.Conclusion:Metabolic bone disease of premature infants is the result of multiple risk factors.This study shows that birth weight and bronchopulmonary dysplasia have an impact on metabolic osteopathy of preterm infants.Birth weight is a protective factor for metabolic bone disease,and the higher the birth weight is,the lower the incidence of metabolic bone disease will be.Bronchopulmonary dysplasia is a risk factor for metabolic osteopathy.Therefore,early diagnosis,early intervention and early prevention should be carried out to prevent premature birth and reduce the occurrence of bronchopulmonary dysplasia.